NURS 5334 EXAM 2 LATEST -

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NURS 5334 EXAM 2 LATEST -

QUESTIONS AND CORRECT DETAILED ANSWERS (100%

VERIFIED ANSWERS) ||ALREADY GRADED A+

• What are the basic mechanisms by which neuropharmocologic agents act?

• Can modify the disease process
• Act at the sites of actions which is the axons versus synapses and steps in synaptic

transmission and effects of drugs on the steps of synaptic transmission • Transmittter synthesis is the first step in transmission. What are the other 4 steps?

• Transmitter storage, transmitter release, receptor binding, and termination of the

transmission

• True or False: Neuropharmacologic drugs have high selectivity.

• True—the nervous system uses many different receptor types

• Information needed:

• Type of receptors—through which the drug acts

▪ Alpha and beta

• Normal responses to the activation of those receptors

▪ Agonists vs. antagonists

• What the drug in questions does to the receptor function

• What are the 3 functions of ANS?

• Regulates the heart
• Regulates the secretory glands, saliva glands, gastric, sweat, and bronchial
• It regulates smooth muscles: bronchi, blood vessels, urogenital system, and the GI tract

• What are the regulatory functions of the parasympathetic NS?

• Seven regulatory functions

▪ Slowing the heart rate ▪ Increasing the gastric secretions ▪ Emptying the bladder ▪ Emptying the bowel ▪ Focusing the eye for near vision, ▪ Constricting the pupil ▪ Contracting the bronchial smooth muscle

• It also regulates the digestion of food, excretion of waste, control of vision and

conservation of energy • What are the functions of the sympathetic NS?

• Regulation of the cardiovascular system

▪ Maintaining blood flow to the brain ▪ Redistributing blood and compensating for the loss of blood

• Regulation of body temperature

▪ Regulates blood flow to the skin ▪ Promotes the secretion of sweat ▪ Induces piloerection (erection of the hair)

• Implementation of the fight or flight reaction

▪ Increase HR and BP 1 / 4

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▪ Blood shuts away from the skin and visera ▪ Bronchi dilate

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▪ Pupils dilate ▪ Use energy that had been stored • What is the baroreceptor reflex?

• The receptors near the heart monitor BP changes and send the information to the brain
• The brain then activates the Autonomic NS to restore blood pressure to normal
• When BP falls, this reflex causes vasoconstriction and increases cardiac output.
• When BP rises, it causes vasodilation and reduces cardiac output

• Where is acetylcholine employed?

• Most junctions at the peripheral nervous system

• Where is epinephrine and norepinephrine released?

• Norepinephrine—postganglionic neurons
• Epinephrine—adrenal medulla

• What are the cholinergic receptors mediated by? What are the subtypes?

• Receptors that mediate responses to acetylcholine

o Subtypes:

▪ Nicotinic ▪ Muscarinic • Whare are adrenergic receptors mediated by? What are the subtypes?

• Mediate responses to epinephrine and norepinephrine

o Subtypes:

▪ Alphas ▪ Betas ▪ Dopamine • What are the functions of each adrenergic subtype?

• Alpha 1—vasoconstriction, ejaculation and contraction of the bladder neck, and prostate
• Alpha 2—(located in presynaptic junction)—minimal clinical significance
• Beta 1—control the heart

▪ Increase HR, increase force of contraction and velocity of conduction in the AV node; stimulate renin released in the kidney

• Beta 2—bronchial dilation, relaxation of the uterine muscle, vasodilation, glycogenolysis
• Dopamine—dilates renal blood vessels

• Epinephrine can activate all alpha and beta receptors but not dopamine receptors • Norepinephrine can activate alpha1, alpha2, and beta receptors but not beta2 or dopamine receptors • Dopamine can activate alpha1, beta1 and dopamine receptors • Muscarinic agonists mimic the effects of acetylcholine at muscarinic receptors • Muscarinic antagonists selectively blood the effects of acetylcholine (and other muscarinic agonists) at muscarinic receptors • What are therapeutic uses of Bethanechol?

• Urinary retention
• Investigational GI uses—off label GI reflux

• What are actions on smooth muscle, exocrine glands, and eye?

• Smooth muscle—

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▪ lung by causing constriction of the bronchi ▪ the GI system by increasing tone and motility ▪ the bladder by contraction of the detrusor muscle ▪ relaxation of the trigone and sphincter

• Exocrine glands—increased sweating salivation, bronchial secretions and secretion of

gastric acid

• Eye—causes miosis and contraction of the ciliary muscle

• Adverse Effects?

• Hypotension
• Abdominal cramps
• Diarrhea
• Increased salivation
• Exacerbate asthma
• Can cause dysrhythmias in patients with hyperthyroidism

• What are cevimeline, pilocarpine, and acetylcholine used for?

• Cevimeline—treat dry mouth and Sjogren’s syndrome
• Pilocarpine—topical treatment of glaucoma as well as dry mouth from Sjogren’s

syndrome

• Acetylcholine—rapid myosis after delivery and cataract surgery

• Anticholinergics

• Competitively block the actions of acetylcholine as muscarinic receptors
• Most muscarinic receptors are on structures innervated by parasympathetic nerves
• Also known as parasympatholytic drugs, antimuscarinic drugs, muscarinic blockers, and

anticholinergic drugs

• Anticholinergic drugs: produce selective blockade of the muscarinic receptors (not all

cholinergic receptors)

• Can’t pee, see, spit or shit

• What are the pharmacologic effects of atropine?

• The heart—increases in rate
• The exocrine glands—decrease secretions
• Smooth muscle—relaxes the bronchi, decreases the tone of the urinary bladder detrusor

and decreases the tone motility of the GI tract

• Mydriasis and cycloplegia in the eyes
• Mild excitation to hallucinations and delirium in the Central Nervous system

• Therapeutic Uses of Atropine?

• Pre-anesthetic medication to help dry up secretions
• Disorders of the eye
• In codes for bradycardia, intestinal hypertonicity and hypermotility
• Muscarinic agonist poisoning
• Peptic ulcer disease
• Asthma
• Biliary colic

• Side effects of Atropine

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